@extends('layouts.container') @section('title', 'Pendaftaran Tambahan Sub Spesialis') @section('title_description', 'Edit Pendaftaran Tambahan Sub Spesialis: ' . $pendaftaranKompetensi[0]->no_registrasi) @section('css') @endsection @section('body-class', 'skin-black') @section('content') @if ($errors->count())
    @foreach ($errors->all() as $item)
  1. {{ $item }}
  2. @endforeach
@endif {{ Form::model($pendaftaranKompetensi, ['route' => ['kompetensitambahanpendaftaran-edit-data', $pendaftaranKompetensi[0]->id_register_sp], 'method' => 'PUT', 'files' => true]) }}
{{ Form::submit('Simpan Perubahan', ['class' => 'btn btn-primary']) }}

Registrasi

{{ Form::label('no_registrasi', 'Nomor Registrasi') }} {{ Form::text('no_registrasi', $pendaftaranKompetensi[0]->no_registrasi, ['class' => 'form-control bg-light-blue-gradient no_registrasi']) }} {{ Form::hidden('migrate3', @$migrate3->id_biodata_dokter, ['class' => 'form-control migrate3', 'id' => 'migrate3']) }}
{{ Form::label('nama_lengkap', 'Nama (sesuai STR/ijasah)*') }}
{{ Form::text('nama_lengkap', $pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->nama_lengkap, ['class' => 'form-control nama_biodata_dokter']) }}
{{ Form::label('npa_idi', 'NPA IDI*') }} {{ Form::text('npa_idi', $pendaftaranKompetensi[0]['BiodataDokter']->npa_idi, ['readonly' => 'readonly', 'class' => 'form-control']) }}
{{ Form::label('tempat_lahir', 'Tempat Lahir*') }} {{ Form::text('tempat_lahir', $pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->tempat_lahir, ['readonly' => 'readonly', 'class' => 'form-control']) }}
{{ Form::label('tgl_lahir', 'Tanggal Lahir*') }}
{{ Form::text('tgl_lahir', $pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->tanggal_lahir, ['readonly' => 'readonly', 'class' => 'form-control datepicker']) }}
{{ Form::label('jenis_kelamin', 'Jenis Kelamin*') }} {{ Form::select('jenis_kelamin', $jenis_kelamin, $pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->jenis_kelamin, ['readonly' => 'readonly', 'class' => 'form-control']) }}
{{ Form::label('alamat', 'Alamat Korespondensi*') }} {{ Form::text('alamat', $pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->alamat, ['readonly' => 'readonly', 'class' => 'form-control']) }}
{{ Form::label('no_telp', 'Nomor Telepon') }} {{ Form::text('no_telp', $pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->nomor_telepon, ['readonly' => 'readonly', 'class' => 'form-control']) }}
{{ Form::label('email', 'Alamat Email') }} {{ Form::text('email', $pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->email, ['readonly' => 'readonly', 'class' => 'form-control']) }}
{{ Form::label('no_hp', 'Nomor HP*') }} {{ Form::text('no_hp', $pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->nomor_hp, ['readonly' => 'readonly', 'class' => 'form-control']) }}
{{ Form::label('no_hp2', 'Nomor HP Alternatif') }} {{ Form::text('no_hp2', $pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->nomor_hp2, ['readonly' => 'readonly', 'class' => 'form-control']) }}
{{ Form::label('keterangan', 'Keterangan') }} {{ Form::select('keterangan', $keterangan, $pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->id_keterangan, ['readonly' => 'readonly', 'class' => 'form-control']) }}
{{ Form::label('pas_foto', 'Foto* (Format: jpg/jpeg/png, ukuran maksimum 2Mb)') }}
{{ Form::file('pas_foto', ['readonly' => 'readonly', 'class' => 'form-control']) }}
{{ substr($pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->file_foto, 0, strpos($pendaftaranKompetensi[0]['BiodataDokter']['Biodata']->file_foto, '#')) }}
{{ Form::label('upload_sk_spesialis', 'Upload Data (Format: pdf, ukuran maksimum 2Mb)') }}
{{ Form::submit('Simpan Perubahan', ['class' => 'btn btn-primary']) }}

Data Tambahan Sub Spesialis

{{ Form::label('tambahan_subspesialis', 'Tambahan Subspesialis') }}
{{ Form::text('tambahan_subspesialis', @$dataSp2Kompetensi->TambahanSubspesialisOrm->tambahan_subspesialis ? @$dataSp2Kompetensi->TambahanSubspesialisOrm->tambahan_subspesialis : old('tambahan_subspesialis'), ['class' => 'form-control tambahan_subspesialis']) }}
{{ Form::label('tempat_rumah_sakit', 'Rumah Sakit Tempat Pelatihan*') }}
{{ Form::text('tempat_rumah_sakit', @$dataSp2Kompetensi->RumahSakitOrm->nama_rumah_sakit ? @$dataSp2Kompetensi->RumahSakitOrm->nama_rumah_sakit : old('tempat_rumah_sakit'), ['class' => 'form-control tempat_rumah_sakit']) }}
{{ Form::label('tgl_mulai', 'Mulai Pelatihan*') }}
{{ Form::text('tgl_mulai', @$dataSp2Kompetensi->mulai_pendidikan ? @$dataSp2Kompetensi->mulai_pendidikan : old('tgl_mulai'), ['class' => 'form-control datepicker tgl_mulai']) }}
{{ Form::label('tgl_lulus', 'Selesai Pelatihan') }}
{{ Form::text('tgl_lulus', @$dataSp2Kompetensi->selesai_pendidikan ? @$dataSp2Kompetensi->selesai_pendidikan : old('tgl_lulus'), ['class' => 'form-control datepicker']) }}

PAPDI Cabang

{{ Form::label('papdi_cabang', 'PAPDI Cabang') }}
{{ Form::input('text', 'papdi_cabang', isset($dataPAPDICabang->nama_institusi) ? $dataPAPDICabang->nama_institusi : @$permission[3]->nama_institusi, ['readonly' => 'readonly', 'class' => 'form-control', $permission[0] ?? '']) }}
{{ Form::close() }} @endsection @section('js') @endsection